One would expect that hermaphrodism during the time period in which Dreger writes would cause major societal rifts and would be even more controversial than it is now. However, if the subject is thought about clearly for any amount of time, it would seem as if society has made no substantial progress in the acceptance of this anomaly. Of course, we have made many technological and biological advancements that help people better understand how and why this condition can occur, but it is still very much a taboo subject. Today, it is my understanding that most children born with both sets of genitalia almost always undergo corrective surgery if it is financially and physically possible, but why? It is because contemporary society has yet to accept this specific bodily phenomena as it has others. This is most likely due to the extreme emphasis we put on issues of sex and gender. Sexual topics, such as gay marriage and gay rights, are huge points of political controversy because they challenge the deeply ingrained heterosexual norm. Therefore, an instance in which an individual physically displays characteristics of both sexes is in direct opposition to every existing perception of what we consider a man and a woman.

It is true that stories of hermaphodism or pseudo-hermaphrodism are rarely talked about in the news or other media outlets. The few cases that I have learned about have been in my medical sciences and biology classes and have involved individuals in far-off countries. Surely there have been more cases of hermaphrodism than those I have learned about, so why hasn’t anyone ever heard of them? Brown University researcher Anne Fausto-Sterling estimated that the total number of people receiving surgery to “normalize” genital appearance was 1 in every 1,000 births (http://www.isna.org/faq/frequency). This estimation is probably considerably higher than what most of us estimated, and it is doubtful that there is a precise number because of the frequency of unreported cases. However, if we take that number as being true, genital variation and hermaphrodism is way more common than society lets on. Therefore, we must ask ourselves the question as to why this is still such a controversial subject in our society, even after all of the progress we have made regarding other topics of sex and gender.

In her book Hermaphrodites and the Medical Invention of Sex Alice Dreger charts the ideological shifts in medical consensus over the classification of hermaphroditic bodies during the mid-19th and early 20th Centuries. While there occurred significant changes in the favored procedures of Western medicine for the treatment of hermaphrodites during this time, Dreger’s description of the Age of Gonads shows how the medical field sometimes oscillated in its favored procedures while at a deeper level remaining in the service of a static idea. In this case the static idea is sexual dimorphism and the procedure is the favored route for determining “true” sex. Dreger writes, “During this period, 1870-1915, what I call the Age of Gonads, scientific and medical men, faced with and frustrated by case after case of ‘doubtful sex,’ came to an agreement that every body’s ‘true’ sex was marked by one thing and one thing only: the anatomical nature of the gonadal tissue as either ovarian or testicular,” (29). At the beginning of said Age, gonads began their reign as the penultimate determiners of sex, and self-evidently, at the end of the Age science turned to other factors such as secondary sex characteristics for sex certainty. This characterization presents a very clear shift from one procedure of sex determination to another, but significantly, both the adoption and the eventual abandonment of gonads as the “true” sex markers were undertaken for the motivation of upholding sexual dimorphism. To demonstrate, when discussing why gonads were initially chosen as sex determiners, Dreger writes, “The gonadal definition of true sex seemed to preserve, in theory and practice, the strict separation between males and females,” (30). In fact, most medical professionals, (a group which, during our era of focus, was comprised almost solely of white, heterosexual males with property or wealth) preached the gospel of sexual difference: “Many men of science, following in the footsteps of the great Charles Darwin, wrote with confidence and enthusiasm about the differences of the male and female types,” (Dreger, 26). Worthy of mention is the fact that sexual dimorphism was generally deployed for the sake of restricting men and women to certain “natural” domains of behavior and opportunity.

When, in 1915, the Age of the Gonads as identified by Alice Dreger comes to a close, it is by the hand of a medical professional named Blair Bell: “Until 1915 when William Blair Bell did so, apparently no medical man dared to openly question the gonadal definition of true sex,” (Dreger, 158). However, while Blair was the one to conspicuously conclude the Age of the Gonads, his reason for prescribing a change in procedure is one which strives to uphold the same ideology of sexual dimorphism which originally catalyzed the advent of the Age. Blair’s abandonment of gonads as the true sex determiners was prompted by his experience with patients such as Dr. Russell Andrews’ patient (as referenced on Dreger’s page 161) who looked like, behaved like, and believed herself to be a woman, but in whom was discovered testicular gonadal tissue. In such a circumstance, if the gonads were to be considered the authorities, there would be a confusing incongruity between the medically official sex and what is aesthetically observable about the person such as the appearance of secondary sex characteristics and gender presentation. This confusion is the antithesis of what is desired by a system which subscribes to sexual dimorphism: the co-mingling of “oppositional” sexual allegiances on a single body dangerously blurs the distinction between the sexes and shatters the glass wall so carefully cultivated by sexual dimorphism between the essential “natures” and capacities of men and women. Dreger writes, “Blair Bell was, like his predecessors and successors, motivated in theory and practice by an interest in maintaining clear, medically sanctioned divisions between the two sexes… Indeed, this was largely the reason Blair Bell suggested the abandonment of the gonad-as-exclusive-marker rule. … If men and women were to be kept distinct, Blair Bell realized, hermaphrodite-sorting would have to be accomplished in such a way as to quiet sex anomalies, not accentuate them,” (165-166). Thus, it is significantly evident that both the rise and fall of the Age of Gonads were dictated by a curiously strong medical loyalty to sexual dimorphism; even more significantly, this persistent piece of ideology has not yet found its overdue grave, and it still continues to influence the practice of medicine and other sciences today.

In other classes I’ve read about Cheryl Chase and the group she created, the Intersex Society of North America (ISNA). However, I know little about the organization or why a new organization was created, the Accord Alliance. So, this week I wanna talk about the ISNA, Accord Alliance, and support groups for intersex individuals.

In Hermaphrodites and the Medical Invention of Sex, Dreger argues that some intersex patients were angry because they were not offered psychological support (200). They, and their families, had to deal with their feelings on their own (200). Many were happy just to find out that they were not alone and not “freaks” (201).

The Intersex Society of North America (ISNA) is devoted to systemic change to end shame, secrecy, and unwanted genital surgeries for people born with an anatomy that someone decided is not standard for male or female.

We have learned from listening to individuals and families dealing with intersex that:

Intersexuality is primarily a problem of stigma and trauma, not gender.

Parents’ distress must not be treated by surgery on the child.

Professional mental health care is essential.

Honest, complete disclosure is good medicine.

All children should be assigned as boy or girl, without early surgery.

ISNA seems to be a hub of information for intersex individuals. Besides their mission, the website offers the history of the group as well as some of the positive changes that have happened. For example, there has been a new standard of care created that is more patient centered, avoids misleading language, and is more cautious about surgery. The website also offers A LOT of information about law, such as how to contact Advocates for Informed Choice, as well as information about the law and sex reassignment and the rulings of recent court cases. The website offers a lot of books, videos, and bibliographies about and for intersex (or DSD) individuals.

However, what exactly is Accord Alliance? Accord Alliance was created in 2008 by ISNA and is a non-profit organization that is dedicated to improving DSD health care. It is comprised of health care and advocacy professionals. So, ISNA is no longer in opperation, it is now Accord Alliance. However, the ISNA website still exists and continues to be an invaluable source of information for intersex individuals and their families.